Impact of geography on organ allocation:Beyond the distance to the transplantation center

作     者：Rony Ghaoui Jane Garb Fredric Gordon Elizabeth Pomfret 

作者机构：Division of GastroenterologyBaystate Medical CenterTufts University School of Medicine Epidemiology/Biostatistics Research CoreBaystate Medical CenterTufts University School of Medicine Department of Trans- plantation and Hepatobiliary DiseasesLahey Medical CenterTufts University School of Medicine 

出 版 物：《World Journal of Hepatology》 (世界肝病学杂志（英文版）（电子版）)

年 卷 期：2015年第7卷第13期

页      面：1782-1787页

学科分类：081603[工学-地图制图学与地理信息工程] 081802[工学-地球探测与信息技术] 1002[医学-临床医学] 07[理学] 08[工学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 070503[理学-地图学与地理信息系统] 0818[工学-地质资源与地质工程] 0705[理学-地理学] 0816[工学-测绘科学与技术] 10[医学] 

基　　金：In part Health Resources and Services Administration contract 234-2005-370011C The content is the responsibility of the authors alone and does not necessarily reflect the views or policies of the Department of Health and Human Services,nor does mention of trade names,commercial products,or organizations imply endorsement by the United States Government 

主　　题：Health geographic's Healthcare disparities Outcome research 

摘      要：AIM:To illustrate the application and utility of Geographic Information System(GIS) in exploring patterns of liver ***,we aim to describe the geographic distribution of transplant registrations and identify disparities in access to liver transplantation across United Network of Organ Sharing(UNOS) region ***:Based on UNOS data,the number of listed transplant candidates by ZIP code from 2003 to 2012 for Region 1 was ***(color-coded) maps were used to visualize the geographic distribution of transplant registrations across the *** interaction analysis was used to analyze the geographicpattern of total transplant registrations by ZIP *** tested included ZIP code log population and log distance from each ZIP code to the nearest transplant center;ZIP code population density;distance from the nearest city over 50000;and dummy variables for state residence and location in the southern portion of the ***:Visualization of transplant registrations revealed geographic disparities in organ allocation across Region *** total number of registrations was highest in the southern portion of the *** interaction analysis,after adjusting for the size of the underlying population,revealed statistically significant clustering of high and low rates in several geographic areas could not be predicted based solely on distance to the transplant center or density of ***:GIS represents a new method to evaluate the access to liver transplantation within one region and can be used to identify the presence of disparities and reasons for their existence in order to alleviate them.